| NPI | 1356846984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101267957) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| 208D00000X General Practice (Licence: VA 0101267957) | |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2024-08-01 |